Sunday, October 08, 2006

Health care coach

Hey, this should be your primary care doctor, right? This article from Forbes.com describes what they call "health care transition coaches," who can help reduce patient's hospital bills and rate of re-hospitalization.

The "transition coach" works with patients on four main areas: medication self-management; the creation of a personal health record maintained by the patient; obtaining timely follow-up care; and developing a plan to seek care if certain symptoms appear.

The program was created to solve problems -- such as conflicting medical advice, medication errors and lack of follow-up -- that often affect patients during periods of transition between sites of care.

This article doesn't say who these coaches are, who pays them, and how they get paid. These are probably agents of the insurance companies, who already dictate how health care is delivered in this country.

The idea of a "health care coach" just sickens me. These concepts are exactly what should be happening in the offices of primary care docs. Unfortunately, this is probably not happening, and that's why these coaches were created. Just another symptom of the broken US health care system. If we treat the symptom and not the overall big picture, the status quo will remain and the frustrations will continue to grow.

8 comments:

The idea makes me angry. I'll occasionally get calls from our insurance company ... note that I've been very expensive for them in the last 3 years. I have an excellent PPS policy ... complete with medication coverage, etc.

Well ... they will call and tell me that they would like to assign me a "patient advocate" ... a what???

I always simply refuse to talk to them on the phone ... so they don't get very far with me.

But seriously - to advocate for me in what way? And for what reason? I'm sure they'd like to have a bit of control over what I'm costing them ...

This "health care coach" silliness sounds like the same sort of thing. The last thing medicine needs today is another bunch of non-medical meddlers getting between the patients and their physicians.

Oh good grief. There's nothing subtle about this, is there? They're basically trying to get case management services without having to pay social work salaries. So they get a lesser or non-trained person with no case management experience or social work skills. Another example of the "dumbing down" of the work force.

I could just tell you all kinds of awful stories about sub-par medical experiences, but sometimes...I don't know. I pulled a lumbosacral muscle awhile back and I went to an urgent care clinic. I was refused pain medication since, "You're a construction worker, you don't need any more pain pills"--assuming, I suppose, that I abuse them. He offfered Celebrex, which I said I've had a reaction to before, to which he said, "You get this, or nothing." Hmm. There are some in the medical field, as with all fields, trades and practices, that simply shouldn't be around people, at all. The fact that some think they can fix this kind of ineptitude with "coaches" and "advocates" makes me giggle nervously to myself.

I thought the concept of a "life coach" was hokey - this is just plain dumb. Like clinkshrink said, case management without the skill. Most of the PCPs I'm familiar with (and especially the ones I've worked for) do include this in their practice - it just makes sense. But, I'm sure there are those that slip through the cracks. That's why someone thought up HMOs, I suppose.

This whole concept represents just another job in the "middleman" industry we call medical insurance. (It isn't actually "insurance", in the sense of providing coverage for the occasional accident or mishap, but rather a "brokerage" system that inserts itself between the doctor=service provider and patient=consumer to pay for services.) Hell, maybe I can get a job doing that when my practice goes under.

A Health Care Transitional coach is a Nurse who helps patients understand how to manage their care. Doctors don't have the time anymore to sit down and do one-to-one teaching on meds on health care management. Home Health Care agencies basically do the same thing as a Health Care Transitional Coach. The only difference is that the coaches don't do IV's, and dressing changes.

I've used a life coach twice and the concept of a "life coach" was great in theory but the first one I went to was just horrible. The second was really helpful, although I could have used more help with change/transition coaching.